{"id":2562,"date":"2015-08-18T13:37:25","date_gmt":"2015-08-18T19:37:25","guid":{"rendered":"http:\/\/admin.patheos.com\/blogs\/janetheactuary\/?p=2562"},"modified":"2015-08-18T22:54:33","modified_gmt":"2015-08-19T04:54:33","slug":"still-missing-the-mark-scott-walkers-health-plan","status":"publish","type":"post","link":"https:\/\/www.patheos.com\/blogs\/janetheactuary\/2015\/08\/still-missing-the-mark-scott-walkers-health-plan.html","title":{"rendered":"Still missing the mark: Scott Walker’s Health Plan"},"content":{"rendered":"\n<\/head>

\"\"<\/p>\n

(image: \u00a0Scott Walker, from wikimedia commons, photo by Gage Skidmore)<\/p>\n

Scott Walker\u2019s released his \u201crepeal and replace\u201d health care plan today. \u00a0Here\u2019s a link<\/a> to a National Review article evaluating the plan, and here\u2019s the plan itself<\/a>.<\/p>\n

There\u2019s a lot that\u2019s good in it, especially the proposed Medicaid reform, which splits Medicaid up into three entities for the three groups served by the program: \u00a0medical care for low-income children and adults, medical care for the disabled and low-income seniors, and long-term care for the disabled and low-income seniors. \u00a0Each of these groups has different needs and should reasonably have services delivered and managed in different ways.<\/p>\n

But here\u2019s my immediate complaint: \u00a0this plan, like others that precede it, proposes per-person tax credits to enable those without employer-provided insurance to purchase health insurance in the private market. \u00a0To be sure, this is an improvement on Obamacare in that there\u2019s no means-testing, no cut-offs and breakpoints that disadvantage those on the wrong side of the cut-off, and an improvement on flat per-family credits that have been proposed before. \u00a0But, in order, I suppose, to simplify things for a nice policy document, he creates four age brackets. \u00a0Do insurance companies price their policies with these age brackets? \u00a0No, of course not. \u00a0Which means that if you fall at the top end of the age bracket, you\u2019re in trouble, and at the bottom end, you come out a bit ahead.<\/p>\n

Here\u2019s my research: \u00a0I looked at ehealthinsurance.com<\/a> for rates, based on a nonsmoker, in my suburban Chicago zip code. (How do we compare against other regions? \u00a0I\u2019m not sure. \u00a0Exercise left for the reader.) \u00a0For all ages, the rates came with a $6,000 deductible. \u00a0The column to the right are the proposed Walker-plan credits. \u00a0And, despite the plan\u2019s claim to the contrary, at the older ages within each range, the credits are far from sufficient to even buy this catastrophic plan.<\/p>\n\n\n\n\n\n\n\n\n\n\n\n
Age<\/strong><\/td>\nDOB<\/strong><\/td>\nMonthly<\/strong><\/td>\nAnnual<\/strong><\/td>\nCredit<\/strong><\/td>\n<\/tr>\n
64<\/td>\n1951<\/td>\n\u00a0$\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 398<\/td>\n\u00a0$\u00a0 4,782<\/td>\n\u00a0$\u00a0\u00a0 3,000<\/td>\n<\/tr>\n
50<\/td>\n1965<\/td>\n\u00a0$\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 237<\/td>\n\u00a0$\u00a0 2,847<\/td>\n\u00a0$\u00a0\u00a0 3,000<\/td>\n<\/tr>\n
49<\/td>\n1966<\/td>\n\u00a0$\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 227<\/td>\n\u00a0$\u00a0 2,719<\/td>\n\u00a0$\u00a0\u00a0 2,100<\/td>\n<\/tr>\n
35<\/td>\n1980<\/td>\n\u00a0$\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 162<\/td>\n\u00a0$\u00a0 1,948<\/td>\n\u00a0$\u00a0\u00a0 2,100<\/td>\n<\/tr>\n
34<\/td>\n1981<\/td>\n\u00a0$\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 161<\/td>\n\u00a0$\u00a0 1,935<\/td>\n\u00a0$\u00a0\u00a0 1,200<\/td>\n<\/tr>\n
18<\/td>\n1997<\/td>\n\u00a0$\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 84<\/td>\n\u00a0$\u00a0 1,012<\/td>\n\u00a0$\u00a0\u00a0 1,200<\/td>\n<\/tr>\n
17<\/td>\n1998<\/td>\n\u00a0$\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 84<\/td>\n\u00a0$\u00a0 1,012<\/td>\n\u00a0$\u00a0\u00a0\u00a0\u00a0\u00a0 900<\/td>\n<\/tr>\n
0<\/td>\n2015<\/td>\n\u00a0$\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 84<\/td>\n\u00a0$\u00a0 1,012<\/td>\n\u00a0$\u00a0\u00a0\u00a0\u00a0\u00a0 900<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

\u00a0<\/p>\n

Now, it should be a simple thing, really \u2014 \u201cMy reform plan provides tax credits sufficient, based on age and location, to buy a typical bronze plan<\/strong>.\u201d \u00a0How hard is this?<\/p>\n

A couple more gripes: \u00a0$6,000 really is quite a large deductible. \u00a0Megan McArdle has suggested deductibles as a percent of pay (sorry, I can\u2019t find the link); in any event, sliding-scale clinics would still play an important role, and should be strengthened (see here for a prior article<\/a>) and made available to the insured with high out-of-pocket costs, in any event. \u00a0But clinics are not hospitals, and don\u2019t help when you need the sort of treatment that only a hospital can provide.<\/p>\n

What\u2019s more, you\u2019ve still got the inequity between employers who do and don\u2019t provide health insurance, and the incentive for employers to cancel insurance coverage and increase pay instead. \u00a0Wouldn\u2019t it be better to give the tax credit to everyone, and factor it into the deductibility of health insurance?<\/p>\n

And you\u2019ve still got the issue of the individual who earns 133% of poverty and gets that one extra dollar raise and loses eligibility, or of disabled adults afraid to get a job because they depend on Medicaid\u2019s complete coverage of their extensive health needs. \u00a0This gulf between Medicaid and Exchange plans, or between Medicaid and Walker\u2019s tax credits, needs to be bridged in some way. \u00a0(Or does the Walker plan propose narrowing Medicaid eligibility, given its sweeping claim to a full ACA repeal?)<\/p>\n

So, it\u2019s a starting point (and better, I\u2019ll admit, than the complete lack of policy documents by some of the other campaigns), but it still needs work.<\/p>\n<\/body><\/html>\n","protected":false},"excerpt":{"rendered":"

(image: \u00a0Scott Walker, from wikimedia commons, photo by Gage Skidmore) Scott Walker\u2019s released his \u201crepeal and replace\u201d health care plan today. \u00a0Here\u2019s a link to a National Review article evaluating the plan, and here\u2019s the plan itself. There\u2019s a lot that\u2019s good in it, especially the proposed Medicaid reform, which splits Medicaid up into three […]<\/p>\n","protected":false},"author":2209,"featured_media":2566,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-2562","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-uncategorized"],"yoast_head":"\nStill missing the mark: Scott Walker's Health Plan<\/title>\n<meta name=\"description\" content=\"(image: \u00a0Scott Walker, from wikimedia commons, photo by Gage Skidmore) Scott Walker's released his "repeal and replace" health care plan today. \u00a0Here's a\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" 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